Ipsilateral radial shaft, head, and medial epicondyle fractures.

Abstract

A patient with a unique combination of ipsilateral midradial shaft (AO/OTA 22-A2), radial head (21-A2), and medial epicondyle (13-A1) fractures, without a recorded elbow dislocation or distal radioulnar joint disruption, is presented. The injury was treated surgically with a dorsal approach to the forearm and a lateral approach to the elbow through a single dorsolateral skin incision. The radial shaft fracture was stabilized using a 3.5-mm limited contact, dynamic compression plate; the radial head, using a 1.2-mm Luhr plate; and the medial epicondyle, using a partially threaded cancellous screw through a limited medial approach. The shaft fracture consolidated by 10 weeks, whereas radiographic consolidation of the radial head fracture was seen at 7 months. At the 15-month follow-up, the patient had achieved an excellent functional result. Awareness of the possibility of double injuries even in yet-unrecognized patterns is warranted when evaluating forearm and elbow trauma.